I realized that in much of my recent conversations about mental illness, I was showing a tendency to focus on, and reply to, the small number of comments that annoyed me, more than the many many many many comments that I found helpful. Partly, I think, this is a symptom of the depression, which is mostly waning but is still leaving me more easily irritated than I usually am. (And partly it’s a symptom of my often ornery, contrary, ranty nature — especially as a writer.)
But a huge amount of what people have been writing has been very helpful. So I wanted to bring out a few particular comments that have particularly stuck with me, and call attention to them. (If I don’t mention your comment here, btw, it doesn’t mean that what you said didn’t help — almost everything that everyone said, with a couple of obvious exceptions that I’ve already responded to, has been helpful, including “That sucks, I’m really sorry.” These are just the comments that particularly resonated with me, in my particular situation.)
I understand that the doctors use “chronic,” but try to think of it as “intermittent depression” instead.
YES, THIS, OMLOG SO MUCH THIS. Calling this “chronic intermittent depression” or “chronic episodic depression” instead of just “chronic depression” is already making a big difference in how I see myself in relation to this illness.
In your place, I’d see it as a mental health seatbelt.
We always use our seatbelts to reduce and avoid injuries. We don’t know for any particular journey whether it’ll be needed at all, or just to restrain us when the car brakes or turns sharply, or to save our lives in a major accident. Your medication at this dosage is ensuring you don’t have major problems from minor incidents. And that if you do have a major “incident” the system is all primed ready to reduce the impact on you and make it easier for serious rescue and repair work without waiting the obligatory try this one now couple of months to see whether/ which, what/ which dosage will help you.
A hugely useful analogy, which I will be using a lot.
Maybe instead of diabetes as your go-to simile, try using asthma.
I’ve had asthma for as long as I can remember. I’ve been on maintenance medication for it since I was in junior high. When I’m on the meds, I can run, exercise, do all the things that normal people do. When I’m not on the meds, running might put me in the hospital.
When I was diagnosed with chronic depression, I was thrilled. I was doing something about the thing that was holding me back from being the me I wanted to be. As far as I am concerned, it is just like getting on asthma meds. I fully expect to be on them the rest of my life, and I’m happy to do so.
I think the “chronic” part of “chronic depression” might be what is throwing you for a loop. It doesn’t mean you’re constantly depressed. It just means that you’re at an elevated *risk* of having an attack of depression. I.e., it isn’t the episodes of depression itself that the “chronic” is referring to. It is the elevated risk. In that way it’s a lot more like asthma. And just like my asthma medications help me be the person I want to be who can run and exercise and stay in shape, the medication for depression helps me be the version of me who has motivation, loves a challenge, loves to learn new things, and has decently high creative output.
-Commenter on Facebook (I’m keeping Facebook comments anonymous unless they self-disclose, out of a possibly misguided and over-cautious notion that people have a slightly higher expectation of privacy on Facebook than they do on blog comments)
Another really useful analogy — for me especially, since I also have asthma (pretty mild), and take meds for it prophylactically, specifically so I won’t have an episode.
Both my wife and I have chronic depression issues, so it helps us to sort of keep an eye on each other, rather than ourselves. That way, we don’t focus on our own anxieties and we can (hopefully) catch the other person before it gets worse
-UnknownEric the Apostate
Good suggestion, and one that a number of people made. I’ll ask the people around me to help me monitor, so I don’t have to do as much of it myself.
Count me among the people who find it very important to not monitor my mood too closely. I suffer from idiosyncratic short-term (few hours to few days) episodes of suicidal ideation and self-loathing. Comparing my current mental state to my “ill” mental state is too close to being in that bad state and can put me there. Like infophile, I use puzzles to distract myself as necessary, or sometimes research.
Instead, I monitor externalities. Did my appetite change? Does a shower seem like too much work? Have I gone a few nights without being able to fall asleep at a reasonable hour? Am I keeping up with housework? Those kinds of things help me know when a bad spell is coming.
Another good way to deal with the possibly overzealous self-monitoring. Thanks.
And, honestly, accepting my chronic depression and general anxiety has really sort of helped deal with both. I choose to see it as sort of an invasive force that I can fight against rather than as, “Well, I guess I’m just Eeyore.”
-UnknownEric the Apostate again
So the solution is to be on the meds all the time, to head off the flare-up. In this it’s no different from taking drugs for herpes.
having a manic depressive husband on meds for life (Zyprexa and wellbutrin), we both think of it just like insulin for diabetes. The brain doesn’t work right, so you need to fix it.
And, recognize that you will have bad days. Dialog with yourself to see if maybe you are just tired/grumpy/frustrated/hungry/annoyed-with-the-whole-damned-world, and if it really is a bad day, do what you need to do. If that means building a fort with the sofa cushions and hiding away with a mug of tea and a book, so be it: taking care of your health isn’t always convenient, but it is always necessary.
-Gregory in Seattle
It might help to identify those telltale signs, whatever they might be for you personally. It really is a process of checking yourself, even just once or twice a day…it doesn’t have to be a big production, and if you’ve had a really good period for a significant length of time (whatever length of time that may be for you), you don’t have to check yourself as often, I’ve found.
Acceptance is hard; it’s really, really hard. There’s no nice way to put it, and yes, it can in itself be depressing. It’s depressing for me because I’ll never know what “normal” or “okay” is like for neurotypical people. I’ve never known that, and their lives, in comparison, seem so much easier, because they can just get up and GO and DO THINGS, you know? Whereas my life involves a ton of planning that other people never have to think about. But I don’t have their lives. I have mine.
Editorial comment: This one fits nicely into the whole “spoons” approach to chronic illness.
I wonder if depression is worse for Atheists because believing you have a soul means you can say that your spirit is normal, it’s just your brain that’s the problem while Atheists believe we are our brain so taking medication is changing something about who we are. Maybe “changing” is the wrong word, I try to see it as “fixing” or “improving”.
What it came down to, for me, was learning to differentiate having a disease from having symptoms. When I tell people I have UC, it’s not the same as when I tell them I am currently Ulcering and need to chill for a second. Similarly, perhaps it would help for you to make a clearer distinction between “I have chronic depression” and “I am currently depressed.” One is a statement of medical vulnerability to certain symptoms; the other is a current state of being. [snip] tl;dr – “I’m upbeat and currently depressed” is a contradiction, but “I’m upbeat and suffer from depression” is not.
In my experience, a generally upbeat, looking-on-the-bright-side attitude is often a coping mechanism for depression: when (nearly) everything seems ultimately hopeless, finding those small bits of possible upsides can prevent utter despair and suicide.
It’s not like finding out you’re chronically depressed means finding out you can no longer be awesome and enjoy things. It just means now you have a better understanding of why your skies are slightly grayer on some days.
I try to tell myself that EVERYONE should do these things–take care of their health, get plenty of exercise–and that it only seems weird because the norms in our culture around self-care and work-life balance and the importance of exercise and social support are all fucked. Which is all true, certainly…. but the fact remains that my body and mind seem more sensitive to the effects of unhealthy living than those of most people.
And that SUCKS, it really does. I hate that many people my age can work 10-12 hour days and eat shit and party multiple nights a week and do fine where as I start to feel myself slide into darkness after skipping yoga for a little over a week because the day job was stressful and I had a stack of freelance work to power through.
I found that the most useful way for me to think about it was to see my cheerfulness as essentially “me” and my depression as distinctly “other”. It helps me to remember that the depression doesn’t define me any more than the rheumatoid arthritis that I will also have to treat for the rest of my life. With both illnesses, I get irritated that I have to take pills every day and that I’ve made some minor lifestyle changes, but I’m symptom free 90% of my life. The illnesses are a huge part of my life experience, and as such they have molded me, but they don’t define me or take away my essential self.
One thing I’ve realized: the depression and anxiety were always there. Always. But I was still an awesome person with them. It’s not like that person when away when I started getting treatment. I can be confident and take-charge and strong and calm in some instances still, even when something’s pushed two fingers into the panic and depression buttons and won’t let up. I just know that there are some areas in which I will not be able to cope without chemical assistance, and I happily accept it, so that I can get back to being the me I like and hopefully stay there a good majority of the time.
Actually, for me at least, the diagnosis was tremendously helpful to me. I’d cycle uncontrollably sometimes, and sincerely believe it was just immaturity or lack of self-control on my part. The diagnosis let me say, in essence, ‘Oh, I’m not crazy after all – there really is something wrong with me.’
-Commenter on Facebook
Your sense is correct, I think, that over-introspecting on what a given mindset or feeling might ‘mean’ is likely to get you into trouble. That’s one of the curses of being intelligent and insightful, and offers another way of understanding the aphorism that ‘ignorance is bliss’. I know from your other posts that you practice a form of mindfulness meditation. You can actually use that to your advantage here; you can use what mindfulness practice has taught you to observe the mood, the inner landscape of your psyche, without having to attach meaning or judgment to it.
-Same Facebook commenter as above
Thanks again to everyone. It is helping a lot. I hope it’s helping others as well.